The Effect Of Perindopril Combined With 'Amiodarone In The Prevention Of Recurrent Af After Simultaneous Radiofrequency Surgical Ablation

Objective:To study the effect of amiodarone and perindopril on the recurrence of atrial fibrillation in patients with valvular heart disease complicated with atrial fibrillation after surgical radiofrequency ablation and the effect of left atrial diameter on the recurrence of atrial fibrillation.Methods:50 patients with valvular heart disease complicated with atrial fibrillation diagnosed in the department of thoracic surgery of affiliated hospital of north sichuan medical college from 2017 to February 2019 were randomly divided into 2 groups with 25 patients in each group.On the day after surgery,patients in the two groups were given 5%glucose water 45ml with amiodarone 450mg intravenously pumped at a rate of 2mlh(the rate was adjusted according to the changes of heart rate and heart rate;The combined group was given oral amiodarone of 200mg qd+perindopril tablets of 8mg qd.The control group was given oral amiodarone 200mg qd after surgery.Warfarin anticoagulation was given to both groups at the same time,and INR was controlled between 1.5 and 2.0.Other antiarrhythmic drugs were not used during the period,and the drugs were discontinued 3 months after the operation in both groups.Routine electrocardiogram was performed on the 1st,3rd,5th and 7th days after the operation,and 24-hour dynamic electrocardiogram was performed when necessary.At the 1st,3rd,6th,9th and 12th month after the operation,routine electrocardiogram or 24-hour dynamic electrocardiogram and color doppler echocardiography were performed.SPSS21.0 software was used for data analysis.Results:1.Left atrial diameter preoperative and postoperative 1 month time there was no statistically difference between the two groups(P>0.05),after each time point were statistically significant difference between the two groups(P<0.05),and the control group were significantly joint group,control group after 6 months,9 months after point was significantly lower than the preoperative and postoperative 1 month time,postoperative time points was significantly lower than in September after 1 month time.2.In about postoperative recurrence of atrial fibrillation,two groups of postoperative recurrence of atrial fibrillation,postoperative recurrence 3 months time there was no statistically significant difference between the two groups(P>0.05),postoperative recurrence 3-6 months time and postoperative recurrence 6-9 months time difference had statistical significance(P<0.05),and the control group were significantly higher than that of joint group,postoperative recurrence time points total 9 months difference was statistically significant(P<0.05),and the control group is significantly higher than the joint group.3.Logistic regression results showed that there was a significant positive correlation between preoperative left atrial diameter and treatment method and recurrence(P<0.05),which were independent risk factors for recurrence(OR>1).Conclusion:1.The administration of perindopril after radiofrequency ablation has a significant anti-atrial remodeling effect,thereby reducing the recurrence of atrial fibrillation in patients with heart valve valve valve combined with atrial fibrillation after radiofrequency ablation.2.The anti-atrial remodeling of perindopril is a slow and long-term process.3.Left atrial diameter is an independent risk factor for the recurrence of af.